A 10-year-old girl was referred with complaints of gait disturbance and incontinence for 6 months and progressive back pain and lower extremity weakness (a power of 3/5) for 10 months. There was tingling sensation in her lower limbs. The patient also had hyperreflexia and upgoing plantars in the lower limbs. She was not able to walk properly. MRI showed an extramedullary cystic lesion compressing the spinal cord (Figure 1). Histopathologic specimen was reported as hydatic disease (HD). Control MRI

A 29-year-old right-handed man presented to our epilepsy monitoring unit for presurgical localization and planning. His typical seizure was captured. During the seizure, he experienced anxiety and déjà vu, followed by intense and intractable retching (Video 1). EEG at the time showed polymorphic delta slowing over the right temporal region that evolves to sharply contoured monomorphic rhythmic delta activity at 2–3 Hz (Video 1). The seizure remained right hemispheric for approximately 5 minutes before

A 58-year-old man with no personal or family history of neuromuscular disorders presented with asymmetric, fluctuating eyelid ptosis, vocal fatigue, nasal regurgitation, tongue mobility issues, and fatigable appendicular weakness. Low-frequency repetitive nerve stimulation of the accessory nerve revealed a significant (11%) and reproducible decremental response. Anti-acetylcholine receptor (AChR) antibodies (25.68 nmol/L) were detected, with no anti-MuSK antibodies. Creatine kinase levels were normal.

A 5-year-old girl with autism-spectrum disorder presented with persistent fever, recurrent episodes of projectile vomiting, increased irritability, and reduced oral intake for 2 months. Neuroimaging showed a left parieto-occipital cystic lesion with multiple septations, perilesional edema, and contrast enhancement of the cyst wall (Figure). Differential diagnoses included a cerebral abscess, cystic tumor, and hydatid cyst. Craniotomy was performed, and the cyst was excised (Video 1), with histopathologic

A 60-year-old man presented with a 3-year history of progressive right foot weakness, numbness, and pain. He had a history of right ulnar neuropathy requiring surgery for removal of a nerve mass. EMG showed chronic severe right sciatic neuropathy and chronic severe right ulnar neuropathy. MRI revealed fusiform thickening with heterogeneous signal of the right sciatic nerve (Figure 1). CSF studies were normal. PET scan was negative. Fascicular sciatic nerve biopsy showed chronic epineural inflammation,

Pathogenic variants in FLNC are associated with myofibrillar myopathy manifesting with either limb girdle-predominant or distal-predominant weakness. 1 A 71-year-old man presented with mild generalized fatigue. Neurologic examination showed asymmetric scapuloperoneal weakness, with bilateral scapular winging, and mild-to-moderate weakness of arm adduction, hip flexion, ankle dorsiflexion, and paraspinals. He had a normal creatine kinase level and no monoclonal gammopathy in serum or urine. Trapezius

A 71-year-old woman presented with bilateral ptosis, exotropia, bilateral nonreactive mydriasis, bilateral vertical gaze palsy, and wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) (Video 1). Brain magnetic resonance imaging revealed a unilateral left thalamic infarction without midbrain involvement (Figure, A and B). Diffusion tensor imaging (tractography) further demonstrated decreased fiber density at the left midbrain-thalamic junction (Figure, C and D). WEBINO variant syndrome is a rare

A 76-year-old woman with secondary progressive multiple sclerosis presented to neuroimmunology clinic with facial spasms. She described horizontal diplopia on right gaze as her initial symptom in 2002. On examination, facial muscle contraction was present with horizontal gaze bilaterally (Video 1). This was most prominent in ipsilateral facial muscles, but bilateral muscle activation was also seen (frontalis and procerus muscles). MRIs showed periventricular, brainstem, and spinal cord T2 hyperintensities

A 71-year-old woman presented with bilateral ptosis, exotropia, bilateral nonreactive mydriasis, bilateral vertical gaze palsy, and wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) (Video 1). Brain magnetic resonance imaging revealed a unilateral left thalamic infarction without midbrain involvement (Figure, A and B). Diffusion tensor imaging (tractography) further demonstrated decreased fiber density at the left midbrain-thalamic junction (Figure, C and D). WEBINO variant syndrome is a rare

Please note there are issues accessing CME on our site. We are actively working to restore access and apologize for the inconvenience. Pathogenic variants in FLNC are associated with myofibrillar myopathy manifesting with either limb girdle-predominant or distal-predominant weakness. 1 A 71-year-old man presented with mild generalized fatigue. Neurologic examination showed asymmetric scapuloperoneal weakness, with bilateral scapular winging, and mild-to-moderate weakness of arm adduction, hip flexion,